White eggs and yellow-brown spots on the pubic-perineal hairs

A 53 year old man presented with a two week history of pubic itch, which was worse at night, and small droplets of blood in his underwear. He reported that during winter he usually bathed once every two to three days (this presentation was during the month of February), and recalled staying at a small guesthouse with poor sanitation three weeks earlier. Cutaneous examination showed numerous white eggs and yellow-brown spots attached to the hair in the pubic-perineal area and adjacent hypogastrium and groin. Serological tests for HIV and syphilis were negative.

Dermatoscopy was performed (fig 1).